Wiki 2 questions

[boozaarn]

If a pt had a screening colonoscopy. polyps were found when in cecum and polypectomy on some was done. D/T pts abdominal discomfort procedure was stopped and additional polyps couldn't be removed. - for this visit I am using the PT modifier.
The same pt is coming back 3 months later to complete the procedure. prep is good and additional polyps removed.
How should I code the second visit? a f/u or screening again. it is not pt to blame that the first visit wasn't seccesful..So if i will code as a f/u pt probabley will pay out of pocket more than with a PT?


second question
A failed attempt by 2 physicians to perform a cannulation for ERCP. the spent 1.5 hours and the procedure was terminated.
should I use a cpt for cannulation with 74 or unlisted cpt for esophagial procedure
or to code to laser as ercp - diagnostic??

thanks

 

[emmap34]

For both the Colonoscopy and the ERCP you should append Modifier 53 for incomplete and send documentation and the insurance should pay based on the dictation. For the Colonoscocpy since incomplete you should be able to bill the second the same a the first as screening since with 53 the first was incomplete.

 

[boozaarn]

its a hospital ASC .

Anyway on the first screening the scop passed the splenic flexture so per CC it is coded to a complete procedure, and when coding it I didn't know thwe pt will be back for an additional polypectomy that they couldn't performe during the first procedure.